A Positive Relationship Exists Between the Triglyceride to Glucose Index and Waist to Hip Ratio with Stroke Risk in Middle Aged and Older Chinese

The triglyceride-glucose (TyG) index, a convenient marker of insulin resistance, is associated with stroke. This study determined the association between the triglyceride-glucose waist-to-hip ratio (TyG-WHR) and stroke. Data from the China Health and Retirement Longitudinal Study (CHARLS) were utilized from baseline in 2011 to the wave six follow-up in 2020. 17,606 participants were screened and the CHARLS cohort was assembled using a multistage probability sampling technique. Participants were comprehensively assessed through standardized questionnaires with face-to-face interviews. Cox proportional hazards regression models were applied to investigate the relationship between the TyG-WHR and the risk of stroke. To identify potential non-linear relationships, Cox proportional hazards regression with smooth curve fitting was used. A total of 4911 patients with 2,338 males (47.6%) and 2,573 females (52.4%) were included in this analysis. A significant association between the TyG-WHR and the risk of stroke was identified utilizing a Cox proportional hazards regression model with cubic spline functions that were characterized by a non-linear relationship. The analysis determined a threshold for the TyG-WHR at 4.635. The association between the TyG-WHR and stroke was not significant (HR: 0.813; 95% CI: 0.662–0.999; P =0.049 ) to the left of the threshold. The association was statistically significant (HR: 1.271; 95% CI: 1.131–1.429; P <0.001 ) to the right of the threshold. The current study demonstrated a positive and non-linear association between the TyG-WHR and stroke risk among middle-aged and elderly Chinese populations. When the TyG-WHR exceeded 4.635, there was a statistically significant positive correlation with the occurrence of stroke. Clinically, reducing the TyG-WHR, especially <4.635, may reduce the risk of stroke. Significance Statement This study determined the association between the TyG-WHR and stroke from CHARLS database.The current study demonstrated a positive and non-linear association between the TyG-WHR and stroke risk among middle-aged and elderly Chinese populations. When the TyG-WHR exceeded 4.635 there was a statistically significant positive correlation with the occurrence of stroke. Clinically, reducing the TyG-WHR, especially <4.635, may reduce the risk of stroke. The study focused on the clinical risk factor for stroke, which is common discussed in the population health around the world.